Efficacy of adjuvant and neoadjuvant therapies for adult orbital sarcomas

Purpose: To report a series of adults with orbital soft tissue sarcoma treated with various combinations of chemotherapy, radiation therapy, and surgery and to report on the efficacy of neoadjuvant therapy in these patients. Methods: The medical records of adults who presented to our institution with orbital soft tissue sarcoma between 2003 and 2008 were reviewed. Outcome measures reviewed included response to chemotherapy, type of surgery, length of follow-up, visual acuity at last follow-up, local recurrence, distant metastasis, disease-free interval, and death. Results: Thirteen patients were identified. Nine had primary orbital lesions, 1 had a locally recurrent orbital lesion, 1 had a secondary tumor extending from the paranasal sinuses, and 2 had metastases in the orbit from primary tumors at other sites. Six patients (46%) had chemotherapy, and 10 (77%) had external-beam radiation therapy; 12 patients (92%) underwent surgical resection. The mean follow-up time for all patients was 26 months (range, 2 months -7 years). Three patients (23%) received preoperative chemotherapy with or without radiation therapy. Two of these patients underwent globe-preserving surgery, and 1 required an orbital exenteration due to the extent of disease even after chemoreduction. Conclusion: Adults with orbital sarcomas may benefit from preoperative chemotherapy with or without radiation therapy. Multidisciplinary care with involvement of medical oncologists and radiation oncologists who are familiar with sarcoma chemotherapy and radiation may benefit these patients.